II. Precautions: Pharmacogenetics

  1. See Pharmacogenetics
  2. Poor metabolizers (2-15%, 20% in asians)
    1. Clopidogrel with reduced conversion to active form (higher risk for stent closure)
    2. Amitriptyline and Nortriptyline risk of toxicity (reduce starting dose by 50%)
    3. Citalopram, Escitalopram, Sertraline risk of toxicity (reduce starting dose by 50%)
    4. Omeprazole blood concentrations are 5x higher (increased efficacy)
  3. Ultra-Metabolizers (18% of Swedes and 18% of Ethiopians)
    1. Citalopram, Escitalopram, Sertraline with reduced effect (consider alternative agents)
    2. Omeprazole blood concentrations are 40% lower
  4. Reference
    1. Sim (2006) Clin Pharmacol Ther 79:103-13 [PubMed]

III. Interactions: Metabolized by CYP2C19 (Substrates)

IV. Interactions: Inhibitor of CYP2C19

  1. Neuropsychiatric drugs
    1. Fluvoxamine (Luvox)
  2. Antibiotics
    1. Isoniazid (INH)
    2. Ritonavir
  3. Miscellaneous
    1. Omeprazole (Prilosec)
    2. Cimetidine

V. Interactions: Inducer of CYP2C19

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Related Studies

Ontology: CYP2C19 protein, human (C0960580)

Definition (NCI) Cytochrome P450 2C19 (490 aa, ~56 kDa) is encoded by the human CYP2C19 gene. This protein is involved in steroid, terpenoid and drug metabolism.
Concepts Amino Acid, Peptide, or Protein (T116) , Enzyme (T126)
MSH C045793
SnomedCT 423556000
English cytochrome P450 CYP2C(mp), cytochrome P450 2C19, human, Cytochrome p450 CYP2C19 enzyme (substance), Cytochrome p450 CYP2C19 enzyme, CYP2C19, cyp2c19, Mephenytoin 4-Hydroxylase, Cytochrome P450-11A, (S)- Limonene 6-Monooxygenase, EC 1.14.13.48, EC 1.14.13.49, (S)- Limonene 7-Monooxygenase, EC 1.14.13.-, (R)- Limonene 6-Monooxygenase, Cytochrome P450-254C, EC 1.14.13.80, Cytochrome P450 2C19, Cytochrome P450, Family 2, Subfamily C, Polypeptide 19, cytochrome P450 CYP2C19 (human), CYP2C(mp) protein, human, CYP2C19, human, CYPIIC19, human, P4502C19, human, cytochrome p-450 mephenytoin 4-hydroxylase, human, mephenytoin hydroxylase, human, propranolol 4-hydroxylase, human, (S)-mephenytoin-4'-hydroxylase, human, CYP2C19 protein, human, Flavoprotein-Linked Monooxygenase, CYPIIC17, CYPIIC19, P450-11A, P450-254C, Cytochrome P450, Subfamily IIC (Mephenytoin 4-Hydroxylase), Polypeptide 19, Mephenytoin 4'-Hydroxylase, Mephenytoin 4-Prime-Hydroxylase, Microsomal Monooxygenase, Xenobiotic Monooxygenase
Spanish enzima CYP2C19 del citocromo p450, enzima CYP2C19 del citocromo p450 (sustancia), CYP2C19